Management & Treattment

Endometriosis
Endometriosis is a female health disorder that occurs when cells from the lining of the womb (uterus) grow in other areas of the body. This can lead to pain, irregular bleeding, and problems getting pregnant Pain is the main symptom of endometriosis. A woman with endometriosis may have:

Painful periods
Pain in the lower abdomen before and during menstruation
Cramps for a week or two before menstruation and during menstruation; cramps may be steady and range from dull to severe)
Pain during or following sexual intercourse
Pain with bowel movements
Pelvic or low back pain that occurs at any time during the menstrual

Polycystic Ovarian Syndrome
(PCOS) is an endocrine and metabolic disorder. It is considered in any woman with acne, hirsutism, menstrual irregularity, or obesity. Patients with PCOS, have anovulation, i.e. they may not produce a follicle cyclically. They may therefore present with primary amenorrhea (i.e. no periods at all), too few periods (oligomenorrhea) or secondary amenorrhea i.e. absence of periods for six months or more. Some may also have excessive, frequent and irregular bleeding (dysfunctional uterine bleeding).

Stress Incontinence
Many women complain of leaking small amounts of urine while coughing and sneezing. This is an important social problem. This happens because the pelvic floor is weak and is
common after childbirth & menopause. Various medicines can help to solve this problem. Some women require surgery where in a Trans Obturator Tape is put near the neck of the bladder to strengthen it.

Aging Gracefully / Menopause
Menopause is an important milestone in the lives of the women. The changes that happen after menopause are not only due to menopause but also related to aging. At menopause the follicles in the ovary are depleted and there is a decline in the hormone levels. This hormone deprivation can lead to changes in the target organs and sometimes these changes will translate into symptoms

Bleeding Problem After 40
Bleeding problems in women especially above 40 years of age. It is also one of the commonest reasons for which the hysterectomy is done .Hysterectomy involves a minimal hospital stay of one night and two days.

DUB (Dysfunctional Uterine Bleeding)
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Is this topic for you?

This topic is for women who want to learn about or have been diagnosed with dysfunctional uterine bleeding (DUB). It is related to changes in hormone levels. If you don't know what kind of bleeding you have, see the topic Abnormal Vaginal Bleeding.

What is dysfunctional uterine bleeding?

Dysfunctional uterine bleeding is irregular bleeding from the uterus. For example, you may get your period more often than every 21 days or farther apart than 35 days. Your period may last longer than 7 days. It is not serious, but it can be annoying and disrupt your life.

In most cases, this problem is related to changes in hormone levels. It is not caused by other medical conditions, such as miscarriage, fibroids, cancer, or blood clotting problems. Your doctor will rule out these and other causes of vaginal bleeding to confirm that you have dysfunctional uterine bleeding

What causes dysfunctional uterine bleeding?

Dysfunctional uterine bleeding is usually caused by changes in hormone levels. In some cases the cause of the bleeding isn't known.

Normally one of your ovaries releases an egg during your menstrual cycle. This is called ovulation. Dysfunctional uterine bleeding is often triggered when women don't ovulate. This causes changes in hormone levels and in some cases can lead to unexpected vaginal bleeding.

Women can also get this condition even though they ovulate, although this is less common. Experts don't fully understand this type of vaginal bleeding. It may be caused by changes in certain body chemicals.

What are the symptoms?

You may have dysfunctional uterine bleeding if you have one or more of the following symptoms:

You get your period more often than every 21 days or farther apart than 35 days. A normal adult menstrual cycle is 21 to 35 days long. A normal teen cycle is 21 to 45 days.

Your period lasts longer than 7 days (normally 4 to 6 days).

Your bleeding is heavier than normal. If you are passing blood clots and soaking through your usual pads or tampons each hour for 2 or more hours, your bleeding is considered severe and you should call your doctor

Talk to your doctor if you have had irregular vaginal bleeding for three or more menstrual cycles or if your symptoms are affecting your daily life.

How is dysfunctional uterine bleeding diagnosed?
Your doctor must first rule out all other causes of vaginal bleeding before diagnosing dysfunctional uterine bleeding. These causes include miscarriage and problems with pregnancy. Vaginal bleeding may also be caused by common conditions, such as uterine fibroids.

Your doctor will ask how often, how long, and how much you have been bleeding. You may also have a pelvic exam, urine test, blood tests, and possibly an ultrasound. These tests will help your doctor check for other causes of your symptoms. He or she may also take a tiny sample (biopsy) of tissue from your uterus for testing.

Dysfunctional Uterine Bleeding - Topic Overview

How is it treated?

There are many things you can do to treat dysfunctional uterine bleeding. Some are meant to return the menstrual cycle to normal. Others are used to reduce bleeding or to stop monthly periods. Each treatment works for some women but not others. Treatments include:

Hormones, such as a progestin pill or daily birth control pill (progestin and estrogen). These hormones help control the menstrual cycle and reduce bleeding and cramping.

A short course of high-dose estrogen. Estrogen is a hormone that is often used to stop dangerously heavy bleeding.

Use of the levonorgestrel IUD, which releases a progesterone-like hormone into the uterus. This reduces bleeding while preventing pregnancy.

Rarely used medicines that stop estrogen production and menstruation, such as gonadotropin-releasing hormones. These drugs can cause severe side effects but are used in special cases.

Surgery, such as endometrial ablation or hysterectomy, when other treatments do not work.

If you also have menstrual pain or heavy bleeding, you can take regular doses of a nonsteroidal anti-inflammatory drug (NSAID), such as ibuprofen.

In some cases, doctors use watchful waiting, or a wait-and-see approach. It may be okay for a teen or for a woman nearing menopause. Some teens have times of irregular vaginal bleeding. This usually gets better over time as hormone levels even out. Women in menopause can expect their periods to stop. They may choose to wait and see if this happens before they try other treatments.

is this topic for you?

This topic is about urinary tract infections in teens and adults. For information about infections in babies and young children, see the topic Urinary Tract Infections in Children.

What is a urinary tract infection?

Your urinary tract is the system that makes urine and carries it out of your body. It includes your bladder and kidneys and the tubes that connect them. When germs get into this system, they can cause an infection.

Most urinary tract infections are bladder infections. A bladder infection usually is not serious if it is treated right away. If you do not take care of a bladder infection, it can spread to your kidneys. A kidney infection is serious and can cause permanent damage.

What causes urinary tract infections?

Usually, germs get into your system through your urethra, the tube that carries urine from your bladder to the outside of your body. The germs that usually cause these infections live in your large intestine and are found in your stool. If these germs get inside your urethra, they can travel up into your bladder and kidneys and cause an infection.

Women tend to get more bladder infections than men. This is probably because women have shorter urethras, so it is easier for the germs to move up to their bladders. Having sex can make it easier for germs to get into your urethra.

You may be more likely to get an infection if you do not drink enough fluids, you have diabetes, or you are pregnant. The chance that you will get a bladder infection is higher if you have any problem that blocks the flow of urine from your bladder. Examples include having kidney stones or an enlarged prostate gland.

For reasons that are not well understood, some women get bladder infections again and again.

What are the symptoms?
You may have an infection if you have any of these symptoms:
You feel pain or burning when you urinate.
You feel like you have to urinate often, but not much urine comes out when you do.
Your belly feels tender or heavy.
Your urine is cloudy or smells bad.
You have pain on one side of your back under your ribs. This is where your kidneys are.
You have fever and chills.
You have nausea and vomiting.
Call your doctor right away if you think you have an infection and:
You have a fever, nausea and vomiting, or pain in one side of your back under your ribs.
You have diabetes, kidney problems, or a weak immune system.
You are older than 65.
You are pregnant.
How are urinary tract infections diagnosed?
Your doctor will ask for a sample of your urine. It is tested to see if it has germs that cause bladder infections.

How are they treated?

Antibiotics prescribed by your doctor will usually cure a bladder infection. It may help to drink lots of water and other fluids and to urinate often, emptying your bladder each time

If your doctor prescribes antibiotics, take the pills exactly as you are told. Do not stop taking them just because you feel better. You need to finish taking them all so that you do not get sick again.

Can urinary tract infections be prevented?

Drink lots of water every day.
Urinate often. Do not try to hold it.
If you are a woman, urinate right after having sex.
Postmenopausal women may want to ask their doctors about using vaginal estrogen to prevent recurrent UTIs.

Frequently Asked Questions

Learning about urinary tract infections:

What is a urinary tract infection?
What causes these infections?
What are the symptoms?
Why are they more common in women than in men?
Why are older adults at increased risk?
What can I do to prevent a bladder infection?

Being diagnosed
How are these infections diagnosed?
When is additional testing needed?
What other conditions might be causing my symptoms

Getting treatment: How are urinary tract infections treated?

What can I do at home to treat an infection?
What can I do to prevent future infections?
Can antibiotics prevent future infections?

Sexually Transmitted Infections
Sexually transmitted infections (STIs) are diseases passed on from one person to another through unprotected sex (sex without a condom) or sometimes through genital contact.

You can get tested for STIs at a sexual health clinic, GUM (genitourinary medicine) clinic or GP surgery.

This page gives an overview of the different STIs and provides links to more information on these conditions.

Chlamydia

Chlamydia is one of the most common STIs in the UK. Most people who have chlamydia don’t notice any symptoms and won’t know they have the infection. Otherwise, symptoms may include pain when you urinate, unusual discharge and, in women, bleeding between periods or after sex.
Diagnosing chlamydia is easily done with a urine test or a swab of the affected area. Chlamydia is easily treated with antibiotics, but can lead to serious long-term health problems if it's left untreated.
Read more about chlamydia.

Genital warts

Genital warts are small fleshy growths, bumps or skin changes that appear on or around your genital or anal area. They are the result of a viral skin infection caused by the human papillomavirus (HPV).
You don't need to have penetrative sex to pass the infection on because HPV is spread by skin-to-skin contact.
Several treatments are available, such as creams and cryotherapy (freezing the warts).
Read more about genital warts.

Genital herpes

Genital herpes is a long-term condition caused by the herpes simplex virus (HSV).
After you have become infected, the virus remains dormant (inactive) for most of the time. There are often few or no initial symptoms. However, certain triggers can activate the virus, causing outbreaks of painful blisters on your genitals and the surrounding areas.
There's no cure for genital herpes, but the symptoms can usually be effectively controlled using antiviral medicines.
Read more about genital herpes.

Gonorrhoea

Gonorrhoea is a bacterial infection that can cause an unusual discharge from your vagina or penis, and pain when urinating.
Gonorrhoea can be easily diagnosed through a simple swab test and treated with antibiotics. If left untreated, it can lead to more serious long-term health problems and infertility.
Read more about gonorrhoea.

Syphilis

Syphilis is a bacterial infection that causes a painless but highly infectious sore on your genitals or sometimes around the mouth. The sore lasts two to six weeks before disappearing.

Secondary symptoms, such as a skin rash and sore throat, then develop. These may disappear within a few weeks, after which you have a symptom-free phase.

If diagnosed early, syphilis can be easily treated with antibiotics, usually penicillin injections. But if it is left to progress untreated, syphilis can go on to cause serious conditions such as stroke, paralysis, blindness or death.
Read more about syphilis.

HIV

HIV is a virus most commonly caught by having unprotected sex or sharing infected needles to inject drugs.
The virus weakens your ability to fight infections and cancer. AIDS is the final stage of HIV infection, when your body can no longer fight life-threatening infections. There's no cure for HIV but there are treatments to enable most people with the virus to live a long and healthy life.
Read more about HIV and AIDS and Coping with a positive HIV test.

Trichomoniasis

Trichomoniasis is a condition caused by a tiny parasite called Trichomonas vaginalis.

Women may have soreness and itching around the vagina and a change in vaginal discharge. Men may experience pain after urination and ejaculation.
Most men and women are treated with an antibiotic called metronidazole, which is very effective.
Read more about trichomoniasis.

Pubic lice

Pubic lice ('crabs') are tiny blood-sucking insects that live in coarse human body hair, most commonly pubic hair. They cause itching and red spots.

the counter in most pharmacies, or from a GP or GUM clinic.
Read more about pubic lice.

Scabies

Scabies is a contagious skin condition in which the main symptom is intense itching. It's caused by tiny mites that burrow into the skin.
Scabies isn't only spread through sexual contact, but also through skin-to-skin contact for long periods of time with someone who is infected.
It's treated with cream containing insecticides, which kills the scabies mite.
Read more about scabies.

Vaginal Infection
If you have pain, itching, or other symptoms around your vagina, don’t try to treat them yourself. Don’t risk your health. See a doctor or other health care provider who can figure out the cause and right treatment.

Signs that you may have an infection include itching, burning, or pain in or around your vagina. If you’ve had sexual contact with someone, these signs may mean that you have a sexually transmitted infection. Not all vaginal infections are caused by sexual contact. But any time you have itching, burning, or pain, you need to see a doctor to get treated. This section explains the types of infections you can get without sexual contact.

Types of infections
Ways to avoid infections

Types of infections top

Two common vaginal infections are yeast infections and bacterial vaginosis.

Bacterial vaginosis (BV) happens when a certain kind of bacteria (a type of germ) that’s in your vagina grows too much. Possible symptoms include:

A bad smell from your vagina that might seem “fishy”
More discharge (fluid) from your vagina than you normally have
Discharge that is gray or white and “milky”
Itching around your vagin

It’s important to see your doctor if you have symptoms. BV can be treated with antibiotics. If BV is not treated, though, it can cause other serious health problems.
Yeast infections happen when a fungus (a type of germ) that’s usually in the vagina grows too much. Possible symptoms include:

Burning, redness, and swelling of the vagina and the vulva
Pain when you urinate
Pain during sex
A thick, white discharge that looks like cottage cheese and does not have a bad smell
A rash on the outside of your vagina

Lots of women think they have a yeast infection when they really have something else. Before trying to treat yourself with an over-the-counter medicine, it’s important to talk with a doctor. That’s especially true if you’ve never had a yeast infection before or if you have them often.

Sometimes you may have symptoms that make you believe you have a vaginal infection, but you instead have a urinary tract infection.

Urinary tract infections (UTIs) happen when bacteria get inside the parts of your body that are involved in making, storing, or removing urine, like your bladder. Symptoms of a urinary tract infection include:

Burning when you urinate
Feeling a need to urinate frequently
Feeling a strong need to urinate but only a little urine comes out
Back or stomach pain
Cloudy or dark urine
Fever and chills
Blood in your urine if that happens, tell a doctor right away

UTIs can be cured with antibiotics.
Ways to avoid infections top

You can’t always prevent vaginal infections. But here are some steps you can take to lower your risk:

Help keep the bacteria in your vagina balanced. Wash your vagina and bottom every day with mild soap. When you go to the bathroom, wipe from your vagina toward the back, not the other way.

Keep your vagina cool bacteria love the heat! Avoid tight underwear or clothes made of synthetic fibers that can trap heat. Wear cotton or cotton-crotch underwear.

Change out of wet bathing suits and exercise clothes as soon as possible. Bacteria like wet places too!

Don't douche. Putting water or other products into your vagina removes some of the normal bacteria that protect you from infection.

Avoid scented hygiene products like bubble bath, sprays, pads, and tampons. They can irritate your vagina and lead to an infection.

Change your underwear every day, so you don’t let germs near your vagina.

Drink lots of water. This can help wash out your urinary tract.

Having sex may increase your odds of some infections even if they’re not considered sexually transmitted infections. Abstinence is the safest way to avoid infections. If you are having sex, use a latex condom to lower your risk and protect your health. You can use a polyurethane condom if you or your partner has a latex allergy